Análise clínica e histológica do uso da Matricaria Recutita e da Terapia Fotodinâmica no reparo tecidual em dorso de língua de ratos

Abstract

Introduction: The tissue repair process is important in restoring the function of organs and systems, so it is important to investigate alternatives that contribute to the positive modulation of this process. In this context, Matricaria recutita (chamomile) is indicated for tissue repair, due to its anti-inflammatory properties. In turn, antimicrobial Photodynamic Therapy (aPDT) presents contradictory results in tissue repair. There are no documented reports on the potentiated or non-potentiated effects resulting from the association between these two therapies. Objective: Evaluate the effect of topical chamomile in the management of oral mucositis (OM) in cancer patients and to evaluate this same agent in the repair of an experimental ulcer made in the dorsum of the tongue in rats alone or associated with aPDT. Material and methods: It was a systematic review, which sought articles of the randomized clinical trial in the databases PubMed, Cochrane Library, and Bireme according to the PRISMA parameters, registered in the PROSPERO. Furthermore, an experimental study was carried out with 75 male Wistar rats were submitted to a 5 mm diameter surgical wound made on the dorsum of the tongue. The animals were allocated in the experimental groups: control, chamomile extract fluid (Ad-muc®), chamomile infusion, aPDT, aPDT + chamomile infusion. Euthanasia was scheduled for the 3rd, 7th and 14th day after the surgical procedure. Clinical, histomorphological and histomorphometric analyzes were performed on sections stained with hematoxylin and eosin and red sirius. Results: A total of six articles were included in the systematic review. The results showed that the application of topical chamomile was effective in the prevention and (or) treatment of OM in four of the six studies, with a dose ranging from 1% to 2.5% and duration that ranged from single to four times/day. Regarding the experimental study, when comparing the therapies chosen for ulcers' repair on the dorsum of the tongue, it was noted that the chamomile extract fluid (Ad-muc®) group showed superior clinical (p<0.0001) and histological results, whether in descriptive or inferential analysis (p<0.05). The groups that used chamomile under infusion did not show significant differences in relation to the control group in most of the parameters evaluated, while the groups that underwent aPDT did not modify tissue repair. Conclusion: The application of topical chamomile in the different forms of presentation in the management of chemoinduced OM seems to be well indicated. Additionally, the fluid extract of chamomile (Ad-muc®) showed superiority in tissue repair in oral ulcers in rats. It is recommended that new clinical trials be carried out in order to obtain results that reaffirm these findings and that favor the establishment of effective protocols.